The nurse is performing a head-to-toe assessment of a client and ...

[kfurse]

The nurse is performing a head-to-toe assessment of a client and would expect to palpate the liver in which quadrant?
 
  1. Right lower quadrant
  2. Left upper quadrant
  3. Right upper quadrant
  4. Left lower quadrant

Question 2

Which assessment finding would indicate to the nurse that a client's gastrointestinal tract is functioning adequately?
 
  1. Peristaltic waves seen upon inspection of the abdomen
  2. Lack of a bowel movement for several days
  3. Hypoactive bowel sounds in all four quadrants of the abdomen
  4. Active bowel sounds in all four quadrants of the abdomen

[duke02]

Answer to Question 1

Correct Answer: 3
Rationale 1: The liver is not in the right lower quadrant.
Rationale 2: The liver is not in the left upper quadrant.
Rationale 3: The liver is anatomically positioned in the R costal border.
Rationale 4: The liver is not in the left lower quadrant.
Global Rationale: The liver is anatomically positioned in the R costal border. It does not normally extend to other quadrants.

Answer to Question 2

Correct Answer: 4
Rationale 1: The nurse should not see peristaltic waves by inspecting the abdomen.
Rationale 2: The frequency of bowel movements differs from person to person. Lack of a bowel movement for several days does not indicate adequate or inadequate functioning of the GI tract.
Rationale 3: Hypoactive bowel sounds in all four quadrants of the abdomen do not indicate adequate peristaltic waves or adequate functioning.
Rationale 4: Active bowel sounds are an indication of peristaltic waves and adequate functioning of the GI tract.
Global Rationale: Active bowel sounds, not hypoactive bowel sounds, are an indication of peristaltic waves and adequate functioning of the GI tract. Frequency of bowel movements is not a reliable indicator as this pattern varies widely from individual to individual. The nurse should not be able to see peristaltic waves by inspecting the abdomen.

[kfurse]

Both answers were spot on, thank you once again

[duke02]

Great! Please up vote